The effects of dilute epinephrine saline irrigation on the need for tourniquet use in routine arthroscopic knee surgery

A prospective, randomized, double-blinded study was performed to determine whether dilute epinephrine saline irrigation (1 mg/l) delivered by gravity flow would significantly reduce the need for tourniquet use during routine arthroscopic surgery. One hundred five patients requiring straightforward a rthroscopic knee surgery were randomly assigned to either an epinephrine gr oup that received dilute epinephrine irrigation by gravity flow or to a pla cebo group that received normal saline irrigation by gravity flow. The need for tourniquet use and the tourniquet time, total operative time, and volu me of irrigation fluid used were documented and compared between the two gr oups. A tourniquet was required 50% less often in the epinephrine group tha n in the placebo group. This difference was found to be statistically signi ficant using the Student's t-test (P < 0.008, alpha less than or equal to 0 .05). If a tourniquet was required, the presence of dilute epinephrine in t he irrigation fluid did not affect the overall tourniquet time or the ratio of tourniquet time to total operative time. We believe this study proved t hat dilute epinephrine irrigation is effective in decreasing the need for t ourniquet use during routine arthroscopic knee surgery.